Hand Function Deficiency in Patients with Dupuytren's Disease and Course of Recovery after Palmar Fasciectomy.

PURPOSE OF THE STUDY To evaluate hand function deficiency in patients with Dupuytren's disease (DD) in addition to assessing the improvement of function after palmar fasciectomy by using different hand-related questionnaires. MATERIAL AND METHODS A total of 121 hands (95 patients) underwent surgery. Disease severity was designated using Tubiana's Staging System. The Tendency of changes of Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), Patient Evaluation Measure (PEM), and Hand Function Score (HFS) scores of patients with DD undergoing palmar fasciectomy were assessed prior to, 3 months after, and 1 year after the operation. Moreover, total loss of extension (TLoE) was evaluated using a goniometer in the same time intervals. Repeated measure ANOVA Friedman's test were used. Responsiveness to clinical change was calculated by using standardized response means (SRMs). RESULTS The results showed statistically significant improvement of the originally obtained questionnaire results after 3 months for DASH and HFS and 12 months for all forms; only the PEM and DASH score significantly changed between 3 and 12 months. TLoE before surgery was 144.1 o ±99.6 o ; 3-month and 1-year after surgery: 14.3 o ±58.0 o and 19.3 o ±34.7 o respectively. SRMs for 1 year after surgery was large for PEM (1.11) and medium for DASH (0.7) and HFS (0.79). CONCLUSIONS DASH, PEM, and HFS are valuable tools to monitor the hand function of patients with DD after surgery. Key words:hand function, Dupuytren's disease, palmar fasciectomy.

[The USS (Universal Spine System) in the treatment of thoraco-lumbar spine fractures]. / Zastosowanie USS (Universal Spine System) w leczeniu zlaman czesci piersiowo-ledzwiowej kregoslupa.

The paper present the results of surgical treatment of 15 patients (11 males and 4 females--average age 35.3 years) with thoraco-lumbar spine fractures. Pre-op neurological disorders were found in 4 patients with narrowing of the spinal canal, including 1 case of paraplegia. The decrease of vertebrae height was on average 45%. All patients underwent surgical treatment with transpedicular fixation by means of USS (Universal Spine System). In 7 patients 4 vertebrae were instrumented, the rest of the patients had only 3 vertebrae instrumented. In this latter case arthrodesis was not performed. Post-op, the neurological symptoms receded completely in 3 patients and partially in the case with paraplegia. In 76% of the cases vertebra height was restored completely. Patients were allowed to stand on the 3-4 day post-op. Follow-up was 22 months, and the neurological status of the patients was stabile. No decrease in vertebra height was noticed.

[Mineral changes in the intervertebral disc and facet joints during aging]. / Zmiany mineralogiczne zachodzace w krazku miedzykregowym i stawach kregoslupa w czasie starzenia sie.

The mineralogic examinations of intervertebral disc and cartilages of facet joints, taken from corps of the accidents victims, from the level L4-L5, were performed. At the moment of accident the middle age of victim was 41.2 years (4-87 years). Scanning microscopy, atom absorption, chemical analyses and electron microprobe analyses were used in the examinations. As the result of examinations we found: demineralisation of nucleus pulposus in the intervertebral disc and two kinds of mineralisation of anulus fibrosus--invisible and visible. Invisible mineralization was found as the initial stage of visible mineralization. In the cartilages of fact joints, similarly as in the anulus fibrosus, the visible mineralization was found, characterised by the presence of the different shaped mineral deposits in the microscope. The invisible mineralization characterised by increased content of Ca and P and by changes in the chemical composition of basic cartilage substance Fe, Cu, Pb, Zn, Sr, Na, K. It was detected with very sensitive methods. The very close relations between mineralogic changes in the intervertebral disc and facet joints cartilages were also found. Mineralogic changes in degenerative changes of vertebral column outstrip the radiologic ones.

[Relationship between osteocalcin serum level and radiologic changes in long bone fracture healing--preliminary conclusions]. / Zaleznosc pomiedzy poziomem osteokalcyny w surowicy krwi a obrazem rentgenowskim w przebiegu gojenia zlaman kosci dlugich--doniesienie wstepne.

The osteocalcin serum level was monitored in 6 patients with long bone fracture. Immunohistochemical method was used at the day of fracture and also 7, 10, 14, 21, and 28 days after. In 3 cases an autogenic bone marrow grafting was done and osteocalcin level was monitored. The progressive increase was observed in the 4th week after fracture.

[Mineral changes occurring with age in the intervertebral disks of L4-L5 vertebrae]. / Zmiany mineralogiczne zachodzace wraz z wiekiem w krazku miedzykregowym na poziomie L4-L5.

The results of mineralogical examination of 26 L4-L5 intervertebral discs taken from cadavers has been presented. Radiology did not reveal marked osteoarthritic changes at this level. The age of the individuals at the fatal accident ranged from 4 to 87 years (mean 41.2). -- Scanning microscopy, atom absorbtion spectroscopy and roentgen microscopy was used in the examination. Two age related phenomena were discovered; demineralisation of the nucleus pulposus and mineralisation of the anulus fibrosus. Two types of mineralisation were found; the microscopic one visible as granules of different shape and size consisting of crystalline hydroxyapatite aggregates and the one detectable exclusively by sensitive chemical methods as an increase of Ca and P content and disturbance of the remaining elements content in biological structures.